Multivariate analysis identi fied MLR, albumin/globulin (A/G) ratio, TNF-α, IL-6, and CX3CL1 as independent predictors of MRS1994.<h4>Conclusion</h4>Although sTim-3 and Galectin-9 dysregulation lacked direct clinical relevance, MLR, A/G ratio, cirrhosis status, and inflam matory markers (TNF-α, IL-6, CX3CL1) emerged as robust predictors of disease severity (MELD) and prognosis (MRS1994), highlighting their potential for non-invasive risk stratification in PBC. This evidence concerns the gene TNF and Cirrhosis.